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The Use of Simulation for Undergraduate Surgical Education in Sub-Saharan Africa: A Scoping Review
Date Issued
2023-01-17
Author(s)
Barnabas Tobi Alayande
Callum Forbes
Ornella Masimbi
Paul KingPriest
Natnael Shimelash
Felix Wina
Matthew T. Hey
Godfrey Sama Philipo
Egide Abahuje
Jamie M. Robertson
Steven Yule
Robert Riviello
Abebe Bekele
DOI
10.21203/rs.3.rs-2242593/v1
Abstract
<jats:title>Abstract</jats:title>
<jats:p>Background
The implementation of simulation-based learning for surgical training in sub-Saharan Africa can help prepare trainees to address surgical burden. The current status of simulation for surgical skills training in undergraduate medical education in Africa South of the Sahara needs to be better defined. In this scoping review we aimed to identify gaps in the application of simulation to undergraduate surgical education in sub-Saharan Africa.
Methods
We conducted a scoping literature search using PubMed, Embase, and African Index Medicus in August 2021. Studies reporting data on the use of simulation-based learning for undergraduate or internship surgical training in SSA specific to surgical clerkships, programs or procedures were included in the analysis. There were no language or date restrictions.
Results
We identified 119 studies and included 19 in the final analysis. Most simulation-based learning for undergraduate surgical training in sub-Saharan Africa began recently (2017–2021), and were reported from Eastern Africa (78%). Half were planned as recurring, sustained simulation programs, and only 25% of programs applied simulation to early undergraduate training. Up to 44% of primary care and 32% of first-level hospital essential surgical procedures, as defined by the Disease Control Priority Program (DCP3), are reported as taught by simulation. Only 15% of programs taught non-technical skills and 14% had engineering collaborations.
Conclusions
We found a lack of published simulation-based learning for undergraduate medical education in sub-Saharan Africa for 65% of World Health Organization/World Bank Disease Control Priorities 3-defined essential operations. There is need to expand the range and depth of content, and participant spread. Interdisciplinary, trans-sectoral collaboration will enrich simulation program quality, and assist with expansion to other African regions.</jats:p>
<jats:p>Background
The implementation of simulation-based learning for surgical training in sub-Saharan Africa can help prepare trainees to address surgical burden. The current status of simulation for surgical skills training in undergraduate medical education in Africa South of the Sahara needs to be better defined. In this scoping review we aimed to identify gaps in the application of simulation to undergraduate surgical education in sub-Saharan Africa.
Methods
We conducted a scoping literature search using PubMed, Embase, and African Index Medicus in August 2021. Studies reporting data on the use of simulation-based learning for undergraduate or internship surgical training in SSA specific to surgical clerkships, programs or procedures were included in the analysis. There were no language or date restrictions.
Results
We identified 119 studies and included 19 in the final analysis. Most simulation-based learning for undergraduate surgical training in sub-Saharan Africa began recently (2017–2021), and were reported from Eastern Africa (78%). Half were planned as recurring, sustained simulation programs, and only 25% of programs applied simulation to early undergraduate training. Up to 44% of primary care and 32% of first-level hospital essential surgical procedures, as defined by the Disease Control Priority Program (DCP3), are reported as taught by simulation. Only 15% of programs taught non-technical skills and 14% had engineering collaborations.
Conclusions
We found a lack of published simulation-based learning for undergraduate medical education in sub-Saharan Africa for 65% of World Health Organization/World Bank Disease Control Priorities 3-defined essential operations. There is need to expand the range and depth of content, and participant spread. Interdisciplinary, trans-sectoral collaboration will enrich simulation program quality, and assist with expansion to other African regions.</jats:p>
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